Cannabis use among Canadian Veterans: Associations with the use of other substances, chronic pain conditions, mental disorders, suicide behaviours, and help-seeking

Abstract:Background: A substantial proportion of Veterans experience mental and physical health difficulties, including post-traumatic stress disorder and chronic pain, for which cannabis is sometimes medically authorized. However, relatively little is known about cannabis use among Canadian Veterans. Information on the prevalence of use, as well as the mental health profiles and help-seeking behaviours of Veterans who use cannabis, is important for developing more targeted prevention and intervention services and supports. Methods: The current study used data from Veteran respondents (n=1992) of the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey. Descriptive statistics and logistic regression models were used to examine associations between past 12-month cannabis use and concurrent mental disorders, chronic pain conditions, use of other substances, suicide behaviours, perceived need for care, and help-seeking behaviours. Results: Several participating Veterans (16.7%) reported using cannabis in the past 12-months. Infrequent use of cannabis in the past 12 months was associated with statistically significantly increased odds of current smoking, binge drinking, and post-traumatic stress disorder in fully adjusted models (Adjusted odds ratios [AOR-2]=1.93, 2.58, and 2.37, respectively). Regular use of cannabis in the past 12 months was associated with statistically significantly increased odds of current tobacco smoking, arthritis and any chronic pain condition, several mental health disorders, and suicide ideation in fully adjusted models (AOR-2 ranged from 1.61 to 3.99). Veterans who used cannabis both infrequently and regularly were also statistically significantly more likely to perceive a need for care (AOR-2=2.15 and 4.85, respectively) and report professional help-seeking (AOR-2=2.25 and 5.56, respectively) in the past 12-months compared to Veterans who did not use cannabis. Conclusions: The strong association of past 12-month cannabis use with nicotine, chronic pain, mental disorders, and suicide ideation suggests that Veterans who use cannabis regularly may represent a population with complex needs who may benefit from additional services and supports. Cannabis using Veterans were also more likely to perceive a need for and seek professional help, which provides opportunities for more timely identification and intervention.